Synopsis for November 26, 2004

Introduction of Routine HIV Testing in Prenatal Care ―
Botswana, 2004

Prenatal clinics in Botswana have offered HIV screening and
prevention services since 2001, but low HIV testing rates have hindered the
nation’s mother-to-child HIV prevention efforts. Data released today,
however, found that when Botswana adopted a national routine testing policy,
substantially greater numbers of pregnant women received HIV testing and
learned their status.

PRESS CONTACT:
Office of Communications

CDC, National Center for HIV, STD, and TB Prevention(404) 639-8895

In 2004, several clinics in Francistown, the nation’s second largest
city, switched from an “opt-in” testing policy, where patients receive
pre-test counseling and actively choose to be tested for HIV, to a routine
testing approach, which combines group education about HIV with an
opportunity to decline or “opt-out” of testing. Under the first three months
of the new approach, 90.5 % of women were tested, compared to 75.3% during
the last four months of the previous policy. Still, many women who were
tested never learned their status, due to delays in providing test results
and missed follow-up visits. To further increase the percentage of women who
learn their HIV status and benefit from prevention services, the government
of Botswana plans to train clinic counselors in the use of same-day rapid
testing.

Two Cases of Hantavirus Pulmonary Syndrome ― Randolph
County, West Virginia, July 2004

Hantavirus pulmonary syndrome (HPS) is a rare but potentially fatal
illness caused by viruses of the genus Hantavirus, which are found in the
excreta (i.e. urine, saliva, and feces) of a variety of rodent species.

PRESS CONTACT:
Boris Pelvin, MD

Office of Communications
CDC, National Center for Chronic Disease(404) 639-3286

In July 2004, two cases (one fatal) that occurred in West Virginia
highlight the presence of these viruses throughout the country, and not just
in the Southwest as originally described when U.S. cases were first reported
in 1993. A person can become infected by inhaling contaminated dust, or by
handling rodents or touching one’s nose or mouth after handling contaminated
materials. Rodent control in and around the home, and safe cleanup of rodent
excreta, remain the primary strategies for preventing infection. Safe
cleanup includes spraying with disinfectant prior to cleaning, using gloves,
and washing hands after removing gloves.

Serious Psychological Distress Among Persons with
Diabetes ― New York City, 2003

Diabetes care providers should be alert to recognize, treat or make
referrals for SPD among their patients. But, while recognition and treatment
of SPD is necessary, it may not be sufficient. An integrated program of
physical and mental health care that removes socioeconomic barriers and
improves access to treatment may be needed to improve the overall health of
persons with diabetes and SPD.

Data from New York City indicate that adults with diabetes were twice as
likely as other adults to experience serious psychological distress (SPD),
and that adults with both SPD and diabetes were more likely to report poor
health, live in poverty, lack access to health care, and to have lost a
spouse or partner to separation, divorce or death. Persons with comorbid
diabetes and SPD face formidable economic and social obstacles to receiving
appropriate health care.